In the past, describing the role of RNs was simple because there were few opportunities for variation (Cherry 540). I believe determining whether or not identified actions are within the domain of nursing practice has to do with the role or position that nurse holds in the organization. For example, I am not a nurse manager in the NICU so it would be out of my scope to make decisions reserved for the nurse manager.

As the bedside or staff nurse, my domain includes direct patient care, collaborating with the medical team to continue the plan of care for a patient and assessing for signs and symptoms of improvement or decline. The nurse manager may assume my role but I have not been authorized to assume theirs.

When nurses stray into areas that have not been released to them, even though there may not be legal ramifications, there may be consequences to assuming authority that has been reserved for nurses with certain educational levels or titles. Certain titles are granted because the individual who holds that title is accepting responsibility and have a particular realm of authority attached to them.

Traditional duties and responsibilities of the professional nurse, regardless of practice area or setting, such as the roles of care provider, educator, counselor, client advocate, change agent, leader, manager, researcher, and coordinator of the interprofessional health care team. (2) Duties and responsibilities of the professional nurse that are guided by specific professional standards of practice and usually are carried out in a distinct practice area (e.g., flight nurse, forensic nurse, and occupational nurse) (Cherry 540).

There are many tools that can be used to determine domain; here are a few:

1. The nurse practice act- Is the task within the RN’s scope of practice?

2. Job description and competencies- What has